{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T19:01:05Z","timestamp":1794078065514,"version":"4.8.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,7,5]],"date-time":"2016-07-05T00:00:00Z","timestamp":1467676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004386","name":"Universiti Malaya","doi-asserted-by":"publisher","award":["UMRG 532\u201013HTM"],"award-info":[{"award-number":["UMRG 532\u201013HTM"]}],"id":[{"id":"10.13039\/501100004386","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004386","name":"Universiti Malaya","doi-asserted-by":"publisher","award":["P0026\/2013A"],"award-info":[{"award-number":["P0026\/2013A"]}],"id":[{"id":"10.13039\/501100004386","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Long\u2010term use of antiepileptic drugs (<jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s) is a significant risk factor for vitamin D deficiency in children with epilepsy. The aims of our study were to evaluate the prevalence and risk factors for vitamin D deficiency among Malaysian children with epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study of ambulant children with epilepsy on long\u2010term <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s for &gt;1 year seen in three tertiary hospitals in Malaysia from April 2014 to April 2015. Detailed assessment of pubertal status, skin pigmentation, sunshine exposure behavior, physical activity, dietary vitamin D and calcium intake, anthropometric measurements and bone health blood tests (vitamin D, alkaline phosphatase, calcium, phosphate, and parathyroid hormone levels) were obtained on all patients. Vitamin D deficiency was defined as 25\u2010hydroxy vitamin D [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D] levels \u226435 nmol\/L and insufficiency as 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D levels of 36\u201350 nmol\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 244 children (146 male) participated in the study. Ages ranged between 3.7 and 18.8 years (mean 12.3 years). 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D levels ranged between 7.5 and 140.9 nmol\/L (mean 53.9 nmol\/L). Vitamin D deficiency was identified in 55 patients (22.5%), and a further 48 (19.7%) had vitamin D insufficiency. Multivariate logistic regression analysis identified polytherapy &gt;1 <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 2.16, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.07\u20134.36), age &gt;12 years (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 4.16, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13\u201315.30), Indian ethnicity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 6.97, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.48\u201319.55), sun exposure time 30\u201360 min\/day (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.44, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.05\u20135.67), sun exposure time &lt;30 min\/day (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.83, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.61\u20139.09), and female (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.61, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.31\u20135.20) as statistically significant (p &lt; 0.05) risk factors for vitamin D deficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Despite living in the tropics, a high proportion of Malaysian children with epilepsy are at risk of vitamin D deficiency. Targeted strategies including vitamin D supplementation and lifestyle advice of healthy sunlight exposure behavior should be implemented among children with epilepsy, particularly for those at high risk of having vitamin D deficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13443","type":"journal-article","created":{"date-parts":[[2016,7,5]],"date-time":"2016-07-05T12:03:31Z","timestamp":1467720211000},"page":"1271-1279","source":"Crossref","is-referenced-by-count":54,"title":["Vitamin D deficiency and its risk factors in Malaysian children with epilepsy"],"prefix":"10.1111","volume":"57","author":[{"given":"Choong Yi","family":"Fong","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology Department of Pediatrics Faculty of Medicine University Malaya Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Nie","family":"Kong","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology Department of Pediatrics 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